Project Summary/Abstract Primary care providers play a critical role in identifying and managing early chronic kidney disease (CKD) to prevent both development of end stage renal disease and cardiovascular disease. However, large quality gaps exist in the management of CKD in primary care. In response to the NIDDK's request for ?translational research to improve outcomes in kidney diseases? (RFA-DK-15-009), the goal of this proposed project is to test the feasibility of using a primary care improvement model that incorporates use of health information technology with delivery system redesign, team care and patient activation strategies to improve adherence to CKD clinical practice guidelines in an eighteen month group randomized trial. The project will be conducted in the Primary Care Practices Research Network (PPRNet), a national primary care practice based research network of members who use electronic health records. The 20 ?real world? participating practices will represent a diverse group of patients. Intervention practices will receive reports on adherence to a set of CKD clinical quality measures (CQMs) and participate in activities designed to promote implementation of CKD improvement strategies as guided by the primary care improvement model. Control practices will receive CKD CQM reports. The primary outcomes will be change in practice adherence to CKD CQMs over the 18 month trial. A process evaluation will also be conducted to assess whether the improvement model is implemented as intended. The findings from the project will lead to new evidence on practical and effective approaches for preventing and managing kidney disease in primary care that could be broadly adopted and sustained.